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Clinical outcomes and cost-effectiveness of brief guided parent-delivered cognitive behavioural therapy and solution-focused brief therapy for treatment of childhood anxiety disorders: a randomised controlled trial

Creswell, C., Violato, M., Fairbanks, H., White, E., Parkinson, M., Abitabile, G., Leidi, A. and Cooper, P. J. (2017) Clinical outcomes and cost-effectiveness of brief guided parent-delivered cognitive behavioural therapy and solution-focused brief therapy for treatment of childhood anxiety disorders: a randomised controlled trial. The Lancet Psychiatry, 4 (7). pp. 529-539. ISSN 2215-0366

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To link to this item DOI: 10.1016/S2215-0366(17)30149-9

Abstract/Summary

Background—Half of lifetime anxiety disorders emerge before 12 years of age, however access to evidence-based psychological therapies for affected children is poor. This Randomised Controlled Trial (RCT) compared the clinical outcome and cost-effectiveness of two brief psychological treatments for anxious children referred to routine child mental health settings. Methods—Children (5-12 years) referred to Primary Child and Mental Health Services across Oxfordshire, UK, for anxiety difficulties were randomly allocated (1:1) to brief Guided Parent-Delivered Cognitive Behavior Therapy (GPD-CBT) or Solution Focused Brief Therapy (SFBT). The primary outcome was Clinical Global Impressions of Improvement (CGI-I). Secondary outcomes were absence of primary anxiety diagnosis and all anxiety disorder diagnoses, self- and parent-reported anxiety symptoms and interference. Parents recorded patient level resource use. Quality Adjusted Life Years (QALYs) were derived from the CHU9D. Assessments were conducted pre-, post- (primary endpoint), and 6- months after treatment. Findings—136 patients were assigned to GPD-CBT (n=68) or SFBT (n=68). Analyses were conducted with the intent to treat population. No significant differences were observed on any clinical (CGI-I; Relative Risk (RR) = 1·01 (0·86, 1·19), p = 0·95) or economic (QALY mean difference = 0·006 (-0·009- 0·02), p = 0·42) outcome measure. However, the GPD-CBT treatment was associated with lower costs (mean difference: -£448; 95% CI: -£934, £37; p=0.070). Interpretation— There was no evidence of clinical superiority, however brief GPD-CBT is likely to be a cost-effective alternative to brief psychological treatment (SFBT) and could be considered as a first-line treatment for children with anxiety problems.

Item Type:Article
Refereed:Yes
Divisions:Faculty of Life Sciences > School of Psychology and Clinical Language Sciences > Department of Psychology
Faculty of Life Sciences > School of Psychology and Clinical Language Sciences > Development
Faculty of Life Sciences > School of Psychology and Clinical Language Sciences > Psychopathology and Affective Neuroscience
Faculty of Life Sciences > School of Psychology and Clinical Language Sciences > Anxiety and Depression in Young People (AnDY)
ID Code:69530
Publisher:Elsevier

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